Kawamura Y, Kobayashi M, Shindoh J, et al. - This study sought to distinguish the utility of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG-PET/CT) as a predictor of overall prognosis in patients with hepatocellular carcinoma treated with lenvatinib. Researchers examined 48 consecutive patients who received lenvatinib treatment. They evaluated the oncological aggressiveness of tumors estimated using 18 F-FDG-PET/CT by the analysis of progression-free survival, post-progression survival, and overall survival (OS). Potential confounders for OS during lenvatinib therapy were distinguished by using multivariate analysis. The data demonstrate that lenvatinib has acceptable disease control regardless of estimated tumor differentiation. The outcomes suggested that a high tumor-to-normal liver ratio (≥ 2) is a poor prognostic factor of OS following lenvatinib treatment, while Δtumor-to-normal liver ratio × 103/day provides useful information of disease control status.